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I laugh so hard I almost choke when I think about myself.I do not take a single newspaper, nor read one a month.

Why Do I Get Bunions?

Overview
Bunions Callous Bunion deformities are often part of a more generalized problem related to improper foot motion as you walk. The name for this is "pronation". Wearing orthotics can slow the progress of a bunion deformity. There are presently over 25 types of bunion procedures performed today. The choice of procedure is based on many factors including age, medical history, physical exam, and x-ray evaluation.

Causes
Perhaps the most frequent cause of bunion development is the wearing of shoes with tight, pointed toes, or with high heels that shift all of your body's weight onto your toes and also jam your toes into your shoes' toe boxes. It's estimated that more than 50 percent of women have bunions caused by high-heel shoes, and that nine out of 10 people who develop bunions are women. Bunions can also develop on your little toes, in which case they are called bunionettes or tailor's bunions.

Symptoms
The most common symptoms associated with this condition are pain on the side of the foot. Shoes will typically aggravate bunions. Stiff leather shoes or shoes with a tapered toe box are the prime offenders. This is why bunion pain is most common in women whose shoes have a pointed toe box. The bunion site will often be slightly swollen and red from the constant rubbing and irritation of a shoe. Occasionally, corns can develop between the 1st and 2nd toe from the pressure the toes rubbing against each other. On rare occasions, the joint itself can be acutely inflamed from the development of a sac of fluid over the bunion called a bursa. This is designed to protect and cushion the bone. However, it can become acutely inflamed, a condition referred to as bursitis.

Diagnosis
Orthopaedic surgeons diagnose bunions on the basis of physical examination and weight bearing x-rays. Two angles are assessed, the intermetatarsal angle, that is between the first and second metatarsals (the bones that lead up to the base of the toes). If this angle exceeds 9? (the angle found in the healthy foot) it is abnormal and referred to as metatarsus primus varus. the hallux valgus angle, that is, the angle of the big toe as it drifts toward the small toe. An angle that exceeds 15? is considered to be a sign of pathology.

Non Surgical Treatment
There are many treatment options for bunions and they will vary with the type and severity of each bunion and will also depend on what is causing the symptoms. Bunions are almost always progressive and tend to get larger and more painful with time, how fast this happens may be a function of the fit of the footwear. The initial goal of treatment options is to relieve pressure on the bunion and any symptoms that may be present and to halt or slow the progression of the joint deformity. There is no effective may be "get rid off" a bunion without surgery. There are a number of things that individuals and Podiatrists can do to help the symptoms and slow (if not halt) progression. Bunion Pain

Surgical Treatment
Conservative bunion treatment methods help to reduce the symptoms but they cannot undo changes in the bone to fully correct the condition. If the pain becomes severe and it starts to affect your daily life, then foot bunion surgery may be the best option to correct a hallux abducto valgus. There are a number of different surgical options, depending on the severity of the bony deformity. The two most common types of surgery are Osteotomy. This is the most common type pf surgery and involves removing part of the bony lump and realigning the toes. It is also known as a bunionectomy or exostectomy. The ligaments around the big toe may also need realigning and this will be done at the same time if necessary. Fusion.This is where the joint at the base of the big toe (metatarsophalangeal joint) is fused together, known as an arthrodesis. This is only indicated in severe cases or if other treatments have failed as it severely limits the movement of the big toe.

Prevention
If these exercises cause pain, don't overdo them. Go as far as you can without causing pain that persists. This first exercise should not cause pain, but is great for stimulating blood and lymphatic circulation. Do it as often as you can every day. Only do this exercise after confirming it is OK with your doctor. Lie on your back and lift up your legs above you. Wiggle your toes and feet. Eventually you may be able to rapidly shake your feet for a minute at a time. Use your fingers to pull your big toe into proper alignment. Stretch your big toe and the rest of your toes. Curl them under for 10 seconds, then relax and let them point straight ahead for 10 seconds. Repeat several times. Do this at least once a day, and preferably several times. Flex your toes by pressing them against the floor or a wall until they are bent back. Hold them for 10 seconds, then release. Repeat several times. Grip with your toes. Practice picking up an article of clothing with your toes, dropping it, and then picking it up again. Warm water. Soak your feet for 20 minutes in a bowl of warm water. Try doing the foot exercises while soaking, and also relax and rest your feet. Epsom salts. Add it to your warm foot bath soak.

Overpronation Of The Feet Treatment And Cause

Overview

Overpronation and underpronation describe general foot movements. These terms do not necessarily describe a medical problem with a foot. For example, you can overpronate and not have any problems or symptoms at all. It is important to have your foot structure and symptoms adequately assessed by your prescribing physician and a qualified practitioner. Once the underlying conditions and mechanical faults are assessed, an appropriate treatment plan including possible orthotic and footwear recommendations can be made.Over-Pronation

Causes

There is a relationship between biomechanics and injury that is specific to each body part. Overall though, poor mechanics will either increase the landing forces acting on the body or increase the work to be done by the muscles. Both increase the stress, which, depending on the individual and the amount of running can become excessive and cause injury.

Symptoms

Because overpronation affects the entire lower leg, many injuries and conditions may develop and eventually cause problems not only in the leg and foot, but also the knee, hips and lower back. Pain often begins in the arch of the foot or the ankle. Blisters may develop on the instep, or on the inside edge of the heels. As overpronation continues and problems develop, pain will be felt elsewhere, depending on the injury.

Diagnosis

When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.Foot Pronation

Non Surgical Treatment

Heel counters that make the heel of the shoe stronger to help resist/reduce excessive rearfoot motions. The heel counter is the hard piece in the back of the shoe that controls the foot?s motion from side-to-side. You can quickly test the effectiveness of a shoe?s heel counter by placing the shoe in the palm of your hand and putting your thumb in the mid-portion of the heel, trying to bend the back of the shoe. A heel counter that does not bend very much will provide superior motion control. Appropriate midsole density, the firmer the density, the more it will resist motion (important for a foot that overpronates or is pes planus), and the softer the density, the more it will shock absorb (important for a cavus foot with poor shock absorption) Wide base of support through the midfoot, to provide more support under a foot that is overpronated or the middle of the foot is collapsed inward.

Surgical Treatment

Subtalar Arthroereisis. The ankle and hindfoot bones/midfoot bones around the joint are fused, locking the bones in place and preventing all joint motion. This may also be done in combination with fusion at other joints. This is a very aggressive option usually reserved for extreme cases where no joint flexibility is present and/or the patient has severe arthritic changes in the joint.

What Exactly Is Severs Disease?

Overview

Although the name might sound pretty frightening, Sever's disease is really a common heel injury that occurs in kids. It can be painful, but is only temporary and has no long-term effects. Sever's disease, also called calcaneal apophysitis, is a painful bone disorder that results from inflammation (swelling) of the growth plate in the heel. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow. Sever's disease is a common cause of heel pain in growing kids, especially those who are physically active. It usually occurs during the growth spurt of adolescence, the approximately 2-year period in early puberty when kids grow most rapidly. This growth spurt can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys. Sever's disease rarely occurs in older teens because the back of the heel usually finishes growing by the age of 15, when the growth plate hardens and the growing bones fuse together into mature bone. Sever's disease is similar to Osgood-Schlatter disease, a condition that affects the bones in the knees.

Causes

Sever?s is often present at a time of rapid growth in adolescent athletic children. At this time the muscles and tendons become tighter as the bones become larger. Between 8 - 15 years of age is the usual onset of this condition.

Symptoms

Severs causes swelling, pain and tenderness over the back of the heel. Your child may walk with a limp. Initially the pain may be intermittent occurring only during or after exercise. As the problem gets worse, pain may be present most of the time. The swelling increases and is painful when touched or knocked. It commonly affects boys who are having a growth spurt during their pre-teen or teenage years. One or both knees may be affected.

Diagnosis

A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.

Non Surgical Treatment

See a doctor, who can diagnose the injury and recommend appropriate treatment options. It will be beneficial to rest the affected heel, and to regularly ice the affected area for the first few days. Anti-inflammatory pain medication can reduce pain and swelling, but first check with your doctor. As the pain diminishes a physical therapist can assist with a program of rehabilitation, incorporating stretching and strengthening exercises focused on the calf, shin and hamstring muscles. For a period after the injury has healed the doctor may advise on changes to your training routines that seek to lessen the strain on the heels. Orthotics are often recommended for your shoes in order to correct any biomechanical problems or lend extra support to the heels.

Exercise

Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and repeated several times throughout the day.

Does Posterior Tibial Tendon Dysfunction (PTTD) Always Involve Surgical Teatment ?

Overview
Posterior tibial tendon insufficiency (also called posterior tibial tendon dysfunction or adult acquired flatfoot) has been named literally after failure of the posterior tibial tendon. However, the condition is caused not only by the progressive failure of the posterior tibial tendon; it is also failure of associated ligaments and joints on the inner side of the ankle and foot. This results in collapse of the arch of the foot, along with the deformity which most often becomes the debilitating problem in its later stages. While at the beginning the common symptom is pain over the tendon in the inner part of the hindfoot and midfoot, later on it is the deformity that can threaten a person?s ability to walk. Just as the tendon degenerates and loses its function, other soft tissue on the same inner side of the foot - namely the ligaments - degenerate and fail. Ligaments are responsible for holding bones in place, and when they fail, bones shift to places where they shouldn?t; deformity is the result. The deformity causes malalignment, leading to more stress and failure of the ligaments. Adult Acquired Flat Feet

Causes
There are numerous causes of acquired Adult Flatfoot, including, trauma, fracture, dislocation, tendon rupture/partial rupture or inflammation of the tendons, tarsal coalition, arthritis, neuroarthropathy and neurologic weakness. The most common cause of acquired Adult Flatfoot is due to overuse of a tendon on the inside of the ankle called the posterior tibial tendon. This is classed as - posterior tibial tendon dysfunction. What are the causes of Adult Acquired flat foot? Trauma, Fracture or dislocation. Tendon rupture, partial tear or inflammation. Tarsal Coalition. Arthritis. Neuroarthropathy. Neurological weakness.

Symptoms
Pain and swelling around the inside aspect of the ankle initially. Later, the arch of the foot may fall (foot becomes flat), this change leads to walking to become difficult and painful, as well as standing for long periods. As the flat foot becomes established, pain may progress to the outer part of the ankle. Eventually, arthritis may develop.

Diagnosis
Your podiatrist is very familiar with tendons that have just about had enough, and will likely be able to diagnose this condition by performing a physical exam of your foot. He or she will probably examine the area visually and by feel, will inquire about your medical history (including past pain or injuries), and may also observe your feet as you walk. You may also be asked to attempt standing on your toes. This may be done by having you lift your ?good? foot (the one without the complaining tendon) off the ground, standing only on your problem foot. (You may be instructed to place your hands against the wall to help with balance.) Then, your podiatrist will ask you to try to go up on your toes on the bad foot. If you have difficulty doing so, it may indicate a problem with your posterior tibial tendon. Some imaging technology may be used to diagnose this condition, although it?s more likely the doctor will rely primarily on a physical exam. However, he or she may order scans such as an MRI or CT scan to look at your foot?s interior, and X-rays might also be helpful in a diagnosis.

Non surgical Treatment
Orthotic or anklebrace, Over-the-counter or custom shoe inserts to position the foot and relieve pain are the most common non-surgical treatment option. Custom orthotics are often suggested if the shape change of the foot is more severe. An ankle brace (either over-the-counter or custom made) is another option that will help to ease tendon tension and pain. Boot immobilization. A walking boot supports the tendon and allows it to heal. Activity modifications. Depending on what we find, we may recommend limiting high-impact activities, such as running, jumping or court sports, or switching out high-impact activities for low-impact options for a period of time. Ice and anti-inflammatory medications. These may be given as needed to decrease your symptoms. Adult Acquired Flat Feet

Surgical Treatment
Many operations are available for the treatment of dysfunction of the posterior tibial tendon after a thorough program of non-operative treatment has failed. The type of operation that is selected is determined by the age, weight, and level of activity of the patient as well as the extent of the deformity. The clinical stages outlined previously are a useful guide to operative care (Table I). In general, the clinician should perform the least invasive procedure that will decrease pain and improve function. One should consider the effects of each procedure, particularly those of arthrodesis, on the function of the rest of the foot and ankle.

What Is Adult Aquired FlatFoot ?

Overview

Many patients suffer from a collapsing arch or flat foot which can cause pain, instability and difficulty while walking. This condition is more commonly known as Posterior Tibial Tendon Dysfunction (PTTD). PTTD is a progressive flattening of the arch due to loss of function of the Posterior Tibial tendon. As the foot flattens, the tendon will stretch, become insufficient and lose its ability to function. This can have a direct effect on walking and posture, ultimately affecting the ankle, knee and hip. As the condition progresses, the joints in the hind foot may become arthritic and painful.Acquired Flat Foot




Causes

Damage to the posterior tendon from overuse is the most common cause for adult acquired flatfoot. Running, walking, hiking, and climbing stairs are activities that add stress to this tendon, and this overuse can lead to damage. Obesity, previous ankle surgery or trauma, diabetes (Charcot foot), and rheumatoid arthritis are other common risk factors.




Symptoms

Not everyone with adult flatfoot has problems with pain. Those who do usually experience it around the ankle or in the heel. The pain is usually worse with activity, like walking or standing for extended periods. Sometimes, if the condition develops from arthritis in the foot, bony spurs along the top and side of the foot develop and make wearing shoes more painful. Diabetic patients need to watch for swelling or large lumps in the feet, as they may not notice any pain. They are also at higher risk for developing significant deformities from their flatfoot.




Diagnosis

The diagnosis of tibialis posterior dysfunction is essentially clinical. However, plain radiographs of the foot and ankle are useful for assessing the degree of deformity and to confirm the presence or absence of degenerative changes in the subtalar and ankle articulations. The radiographs are also useful to exclude other causes of an acquired flatfoot deformity. The most useful radiographs are bilateral anteroposterior and lateral radiographs of the foot and a mortise (true anteroposterior) view of the ankle. All radiographs should be done with the patient standing. In most cases we see no role for magnetic resonance imaging or ultrasonography, as the diagnosis can be made clinically.




Non surgical Treatment

Treatment will vary depending on the degree of your symptoms. Generally, we would use a combination of rest, immobilization, orthotics, braces, and physical therapy to start. The goal is to keep swelling and inflammation under control and limit the stress on the tendon while it heals. Avoidance of activities that stress the tendon will be necessary. Once the tendon heals and you resume activity, physical therapy will further strengthen the injured tendon and help restore flexibility. Surgery may be necessary if the tendon is torn or does not respond to these conservative treatment methods. Your posterior tibial tendon is vital for normal walking. When it is injured in any way, you risk losing independence and mobility. Keep your foot health a top priority and address any pain or problems quickly. Even minor symptoms could progress into chronic problems, so don?t ignore your foot pain.

Flat Feet




Surgical Treatment

If conservative treatment fails to provide relief of pain and disability then surgery is considered. Numerous factors determine whether a patient is a surgical candidate. They include age, obesity, diabetes, vascular status, and the ability to be compliant with post-operative care. Surgery usually requires a prolonged period of nonweightbearing immobilization. Total recovery ranges from 3 months to one year. Clinical, x-ray, and MRI examination are all used to select the appropriate surgical procedure.

The Leading Causes And Solutions Of Achilles Tendinitis Pains

Overview

Achilles TendonitisAchilles tendinitis is an inflammation (swelling) of the tendon, which usually occurs as a result of overuse injury. Basketball players are the most susceptible to Achilles tendinitis because of the frequent jumping. Any activity requiring a constant pushing off the foot, such as running or dancing, may result in swelling of the tendon.

Causes

Tight or fatigued calf muscles, which transfer the burden of running to the Achilles. This can be due to poor stretching, rapidly increasing distance, or over-training excessive hill running or speed work, both of which stress the Achilles more than other types of running. Inflexible running shoes, which, in some cases, may force the Achilles to twist. Runners who overpronate (feet rotate too far inward on impact) are most susceptible to Achilles tendinitis.

Symptoms

Patients with an Achilles tendon rupture frequently present with complaints of a sudden snap in the lower calf associated with acute, severe pain. The patient reports feeling like he or she has been shot, kicked, or cut in the back of the leg, which may result in an inability to ambulate further. A patient with Achilles tendon rupture will be unable to stand on his or her toes on the affected side. Tendinosis is often pain free. Typically, the only sign of the condition may be a palpable intratendinous nodule that accompanies the tendon as the ankle is placed through its range of motion (ROM). Patients with paratenonitis typically present with warmth, swelling, and diffuse tenderness localized 2-6 cm proximal to the tendon's insertion. Paratenonitis with tendinosis. This is diagnosed in patients with activity-related pain, as well as swelling of the tendon sheath and tendon nodularity.

Diagnosis

A doctor examines the patient, checking for pain and swelling along the posterior of the leg. The doctor interviews the patient regarding the onset, history, and description of pain and weakness. The muscles, tissues, bones, and blood vessels may be evaluated with imaging studies, such as X-ray, ultrasound, or MRI.

Nonsurgical Treatment

Many physical therapies exist to help with the pain. We have found the combination of modalities, stretching, acupuncture, footwear modification and myofascial release to be very effective. In resilient cases, a promising new treatment called Radial Shockwave may be indicated. The key to the treatment of this, and other foot problems, is an accurate diagnosis. With this, a treatment regimen tailored to you and your specific situation can be devised. We treat many acute and chronic achilles tendinitis in Edmonton and St. Albert, so remember ?it shouldn?t hurt.?

Achilles Tendon

Surgical Treatment

Surgery is considered the last resort. It is only recommended if all other treatment options have failed after at least six months. In this situation, badly damaged portions of the tendon may be removed. If the tendon has ruptured, surgery is necessary to re-attach the tendon. Rehabilitation, including stretching and strength exercises, is started soon after the surgery. In most cases, normal activities can be resumed after about 10 weeks. Return to competitive sport for some people may be delayed for about three to six months.

Prevention

Achilles tendinitis cannot always be prevented but the following tips will help you reduce your risk. If you are new to a sport, gradually ramp up your activity level to your desired intensity and duration. If you experience pain while exercising, stop. Avoid strenuous activity that puts excessive stress on your Achilles tendon. If you have a demanding workout planned, warm up slowly and thoroughly. Always exercise in shoes that are in good condition and appropriate for your activity or sport. Be sure to stretch your calf muscles and Achilles tendon before and after working out. If you suffer from Achilles tendinitis make sure you treat it properly and promptly. If self-care techniques don?t work, don?t delay. Book a consultation with a foot care expert or you may find yourself sidelined from your favourite sports and activities.

What Is Heel Discomfort And Tips On How To Deal With It

Feet Pain

Overview

Plantar fasciitis is a painful inflammation of the plantar fascia, a fibrous band of tissue on the bottom of the foot that helps to support the arch. Plantar fasciitis occurs when this band of tissue is overloaded or overstretched. This causes small tears in the fibers of the fascia, especially where the fascia meets the heel bone. Plantar fasciitis is common in obese people and in pregnant women, perhaps because their extra body weight overloads the delicate plantar fascia. It is also more common in people with diabetes, although the exact reason for this is unknown. Plantar fasciitis also can be triggered by physical activities that overstretch the fascia, including sports (volleyball, running, tennis), other exercises (step aerobics, stair climbing) or household exertion (pushing furniture or a large appliance). In athletes, plantar fasciitis may follow intense training, especially in runners who push themselves too quickly to run longer distances. Worn or poorly constructed shoes can contribute to the problem if they do not provide enough arch support, heel cushion or sole flexibility.




Causes

Factors which may contribute to plantar fasciitis and heel spurs include a sudden increase in daily activities, increase in weight (not usually a problem with runners), or a change of shoes. Dramatic increase in training intensity or duration may cause plantar fasciitis. Shoes that are too flexible in the middle of the arch or shoes that bend before the toe joints will cause an increase in tension in the plantar fascia. Even though you may have run in shoes that are flexible before, now that you have developed plantar fasciitis, make certain that your shoe is stable and does not bend in the midfoot. Check and be certain that your shoes are not excessively worn. Shoes that do not sufficiently control excessive pronation combined with an increase in training can lead to this condition. A change in running style or parameters, such as starting speed work, running on the ball of your foot or sudden increase in hill workouts may lead to problems. All changes should be gradual and not abrupt. Gait changes such as altering your foot strike, switching shoe style, running barefoot or in minimalist shoes should all be made gradually and not abruptly. The "terrible too's" of too much, too soon, too often with too little rest also applies to "too many changes with too little adaptation". Make your changes gradually and allow your muscles, bones, and other body structures to adapt to the alterations you may be attempting.




Symptoms

The major complaint of those with plantar fasciitis is pain and stiffness in the bottom of the heel. This develops gradually over time. It usually affects just one foot, but can affect both feet. Some people describe the pain as dull, while others experience a sharp pain, and some feel a burning or ache on the bottom of the foot extending outward from the heel. The pain is usually worse in the morning when you take your first steps out of bed, or if you’ve been sitting or lying down for a while. Climbing stairs can be very difficult due to the heel stiffness. After prolonged activity, the pain can flare-up due to increased inflammation. Pain is not usually felt during the activity, but rather just after stopping.




Diagnosis

Plantar fasciitis is usually diagnosed by a health care provider after consideration of a person’s presenting history, risk factors, and clinical examination. Tenderness to palpation along the inner aspect of the heel bone on the sole of the foot may be elicited during the physical examination. The foot may have limited dorsiflexion due to tightness of the calf muscles or the Achilles tendon. Dorsiflexion of the foot may elicit the pain due to stretching of the plantar fascia with this motion. Diagnostic imaging studies are not usually needed to diagnose plantar fasciitis. However, in certain cases a physician may decide imaging studies (such as X-rays, diagnostic ultrasound or MRI) are warranted to rule out other serious causes of foot pain. Bilateral heel pain or heel pain in the context of a systemic illness may indicate a need for a more in-depth diagnostic investigation. Lateral view x-rays of the ankle are the recommended first-line imaging modality to assess for other causes of heel pain such as stress fractures or bone spur development. Plantar fascia aponeurosis thickening at the heel greater than 5 millimeters as demonstrated by ultrasound is consistent with a diagnosis of plantar fasciitis. An incidental finding associated with this condition is a heel spur, a small bony calcification on the calcaneus (heel bone), which can be found in up to 50% of those with plantar fasciitis. In such cases, it is the underlying plantar fasciitis that produces the heel pain, and not the spur itself. The condition is responsible for the creation of the spur though the clinical significance of heel spurs in plantar fasciitis remains unclear.




Non Surgical Treatment

Cortisone is a powerful anti-inflammatory and when injected directly into the heel it will work almost immediately. Bear in mind however, that the treatment does not address the root cause of the inflammation, and needs to be repeated every few months. Also note, these injections are quite painful, and most doctors today will consider other, less invasive treatment options first. ESWT (Extra Corporeal Shockwave Treatment). A specialist targets therapeutic shockwaves to the affected heel area. This will stimulate a healing response in the affected tissue and ligaments, resulting in reduced inflammation and pain. This treatment and may take from 3 to 4 months to be fully effective. Extracorpreal Shock Wave Therapy is the latest technology to treat chronic plantar fasciitis. It is a non-invasive treatment and highly recommended for people who have tried other treatment like cortisone-injections, accupuncture etc with little or no success. Electroacupuncture and standard acupuncture are used in the treatment of plantar fasciitis and other foot problems such as neuromas and nerve impingement, numbness in the toes etc. In some cases there is nerve entrapment within the foot combined with referred pain from other areas of the body. Some research suggests that acunpuncture can be effective in the treatment of heel pain. A trigger point is an irritable knot in the muscle tissue. When pressed trigger points are very tender and can cause pain in that specific spot or elsewhere in the body (referred pain). The response to pushing into the knot is a muscle twitch. The foot contains 126 muscles, tendons and ligaments, so there are plenty of 'hiding places' for trigger points. Trigger points in the calf muscles often refer pain directly to the bottom of the foot. Trigger point therapy of the lower leg and foot can therefore be successful in the treatment of plantar fasciitis.

Plantar Fascitis




Surgical Treatment

Most practitioners agree that treatment for plantar fasciitis is a slow process. Most cases resolve within a year. If these more conservative measures don't provide relief after this time, your doctor may suggest other treatment. In such cases, or if your heel pain is truly debilitating and interfering with normal activity, your doctor may discuss surgical options with you. The most common surgery for plantar fasciitis is called a plantar fascia release and involves releasing a portion of the plantar fascia from the heel bone. A plantar fascia release can be performed through a regular incision or as endoscopic surgery, where a tiny incision allows a miniature scope to be inserted and surgery to be performed. About one in 20 patients with plantar fasciitis will need surgery. As with any surgery, there is still some chance that you will continue to have pain afterwards.